April 29, 2019
April 29, 2019
A prospective randomized study designed to compare the efficacy of transcervical vasopressin injection versus vaginal misoprostol in reducing intra -operative blood loss during hysteroscopic mymectomy .
This was a prospective, randomized, study on forty women with symptomatic submucous myoma presented mostly with bleeding and/or infertility scheduled for hysteroscopic myomectomy were randomized to groups (group A) 20 patients transcervical intramyoma vasopressin injection and (group B) 20patients with vaginal misoprostol is used .
|Active Comparator: misoprostol group
20 cases received 400 microgram prostaglandin E1 analogue, misoprostol, (Misotac®, 200 microgram, by SIGMA pharmaceutical industries, Alexandria, Egypt), intra-vaginally, 2 hr before operation.
prostaglandin E1 analogue vaginally inserted two hours before hystertsopic myomectomy to evaluate intraoperative blood loss and operative time needed for completion of myomectomy
|Active Comparator: vasopressin group
20 patients who had hysteroscopic guided intralesional vasopressin injection before hysteroscopic myomectomy
one ampoule of vasopressin was diluted to 50 ml of normal saline, and 10 ml (4 units of vasopressin) was withdrawn in a syringe. Needle was inserted through the working channel of the hysteroscope until its tip was seen. The needle tip was pointed to the site of injection under hysteroscopic guidance during the whole injection technique. Aspiration was done first to avoid intravascular injection of vasopressin. The diluted solution was injected into the surface, especially to parts with dilated vasculature till they blanch.
- symptomatic women presented with bleeding or infertility and scheduled for
- grade 0 and grade 1 submucous myomas
- less than 5 centimeters in diameter
- Patients with grade 2 submucous myoma or more
- patients with submucous myomas larger than 5 cm in diameter
- postmenopausal women
- patients received GnRh analogue in last 6 months
- patients with anticoagulant therapy
- patients with endometrial premalignant or malignant pathologies
- patients with cardiovascular diseases, asthma or impaired kidney functions